05D1063052 CLIA NUMBER - JOSE M PAVIA MD INC

Laboratory Demographics

  • CLIA Code: 05D1063052
  • Facility Name: JOSE M PAVIA MD INC
  • Facility Address: 13768 ROSWELL AVE #101
    CHINO, CA
    ZIP 91710
  • Facility Phone: 909 517-2188
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSE M. PAVIA
  • NPI Number: 1447251145
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1063052
LAB Type Physician Office
Facility Name JOSE M PAVIA MD INC
Street 13768 ROSWELL AVE #101
City CHINO
State CA
ZIP 91710
Phone 909 517-2188
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2025
Certificate Expiration Date 1/3/2027
Facility Type Physician Office
Lab Director JOSE M. PAVIA

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This page was last updated on: 9/29/2025